Imagine you are no longer able to do the many things most us take for granted – tie your shoes, walk to the corner store, pick up a baby.
These are some of the scenarios encountered by anyone who has suffered the loss of a limb.
With one of the largest inpatient amputee services in the country, a designated WSIB Specialty Amputee clinic, and an outpatient amputee clinic, Toronto’s West Park Healthcare Centre sees about 260 amputee patients a year facing these types of challenges. And every year, through the work of its highly-skilled multidisciplinary teams, West Park successfully enables amputee patients and others with physical disabilities to achieve their highest potential.
The Amputee Rehabilitation team treats patients who have undergone limb amputation and/or those with a neurological, muscular or skeletal impairment where mobility and independence can be improved by the use of a prosthetic limb or an orthopaedic brace. Patients come from a vast cross-section of life, but most suffer from peripheral vascular disease such as diabetes. The team also treats those with congenital limb loss, traumatic injuries such as motor vehicle accidents, workplace trauma and cancer.
For inpatients, once they are admitted to the Amputee Rehabilitation service, a full assessment by the rehabilitation team – physiatrists and orthopaedic specialists, physiotherapists, occupational therapists, care coordinators, nurses, prosthetists and dietitians – is conducted. Along with the patient, the team sets non-prosthetic and/or prosthetic goals, followed by rigorous follow-up to ensure the fit and function of the prosthetic device.
Typically, amputee inpatients begin rehabilitation about 10 days after surgery. During this period, they are taught to function independently without a prosthesis. Rehabilitation and patient education focus on helping the patient learn to regain mobility and use assistive devices such as wheelchairs and other equipment to help them become more independent. Special attention is given to wound care, as well as exercise training to re-build strength and endurance.
Pamela Madan-Sharma, Service Manager for Amputee and Neurological Rehabilitation says West Park’s collaborative care begins with pre-prosthetic goals, which ultimately help achieve better outcomes. “The multi-disciplinary team works together with the patient and their family to promote functional independence with a program that focuses on pre-prosthetic goals,” she says.
Early in their recovery, learning to hop, access the washroom, climb stairs, and access the environment at the wheelchair level are just a few of the critical skills West Park teaches patients.
Following the assessment, pre-prosthetic “conditioning” takes place and a prosthetic mold is manufactured by the technical department to create a preparatory prosthetic device. West Park offers the only adult amputee rehabilitation program in the Greater Toronto Area with onsite manufacturing capabilities for prosthetics and orthopaedic braces – enabling patients to access same-day prosthetic and orthotic fittings, tune-ups and adjustments.
Sheila Brennan, an amputee patient, says having all components under one roof helped her immensely during her recovery. “West Park is a great place to get your life back as everything is in one place. The kind and compassionate staff not only teach you how to adjust to a new way of walking but also how to manage all life skills,” says Brennan.
In preparation for discharge, patients receive counseling and education to assist them being independent at home. Much care is taken to ensure the best possible fit and function of the device at time of discharge.
For six to eight months following the fitting of the preparatory device, the patient’s limb will undergo a maturation process requiring that the fit of the device be adjusted regularly. Once limb volume has stabilized, a definitive device is prescribed to best suit the needs and abilities of the patient.
Never satisfied with the status quo, West Park adopts swift technological advancements in upper and lower limb devices. Upper-limb amputees have seen enormous improvements ranging from cosmetic restoration to myoelectric devices such as the i-Limb and ProDigits hands and fingers while lower-limb prosthetic breakthroughs have included advancements in microprocessor knees.
With advances in both technology and best practices, the Amputee Rehabilitation service looks forward to improving the lives of West Park patients for years to come.